scholarly journals The EWTD 'triple whammy': hitting surgical trainees where it hurts

2007 ◽  
Vol 89 (1) ◽  
pp. 26-28 ◽  
Author(s):  
RM Heath ◽  
TCS Gate ◽  
CM Halloran ◽  
M Callaghan ◽  
MT Paraoan ◽  
...  
Keyword(s):  
Working Hours ◽  
Training System ◽  
Training Time ◽  
Working Lives ◽  
Surgical Trainees ◽  
European Working ◽  
Trainee Surgeon ◽  
Competency Based ◽  
The Uk ◽  
Working Time Directive

Surgical training in the UK has undergone a revolution following Calmanisation and the implementation of the European Working Time Directive (EWTD). The former envisaged that reduced training time would be compensated for by a more structured, competency-based training system centred upon surgical consultant supervision and regular assessment. The EWTD on the other hand aims to improve the working lives of hospital doctors and to improve patients' safety, as well as to comply with EU law by reducing working hours to 56 by August 2004 and further to 48 hours by 2009. No trainee surgeon can now work longer than 13 hours without rest.

scholarly journals More Trainees and Less Operative Exposure: A Quantitative Analysis of Training Opportunities for Junior Surgical Trainees

2010 ◽  
Vol 92 (5) ◽  
pp. 170-173 ◽  
Author(s):  
EC Toll ◽  
CR Davis
Keyword(s):  
Postgraduate Medical Education ◽  
Working Hours ◽  
Training Time ◽  
Surgical Services ◽  
Medical Careers ◽  
Surgical Trainees ◽  
European Working ◽  
The Uk ◽  
Working Time Directive ◽  
Training Opportunities

The evolution of postgraduate medical education in the UK continues to influence the quality of surgical training. Many reforms over the last three decades have affected training, including the Calman reforms, Modernising Medical Careers (MMC) and the European Working Time Directive (EWTD). The net effect of these changes is a reduction in working hours and shorter total training time for surgical trainees. Compounded by increasing subspecialisation, centralisation of surgical services and surgeon-specific data reporting, there may be fewer operative opportunities for surgical trainees.

The Lost Generation: Impact of the 56-hour EWTD on Current Surgical Training

2010 ◽  
Vol 92 (3) ◽  
pp. 102-106 ◽  
Author(s):  
CR Chalmers ◽  
S Joshi ◽  
PG Bentley ◽  
NH Boyle
Keyword(s):  
Shift Work ◽  
Surgical Training ◽  
New Deal ◽  
Working Hours ◽  
Lost Generation ◽  
Surgical Trainees ◽  
European Working ◽  
Working Time Directive ◽  
Training Opportunities ◽  
The New Deal

The reform of specialist surgical training – the New Deal (1991), the Calman report (1993) and the implementation of the European Working Time Directive (EWTD, 1998) – has resulted in shorter training periods with reduced working hours. The Calman reform aimed to improve and structure training with regular assessment and supervision whereas the New Deal and the EWTD have concentrated predominantly on a reduction in hours. The adoption of full or partial shift work to provide surgical cover at night compliant to a 56-hour working week, as stipulated by phase one of the EWTD, has resulted in daytime hospital attendance for surgical trainees of an average three days per week despite almost universal acknowledgement of the limited training opportunities available at night.

Basic surgical training outcomes in the era of the EWTD

2006 ◽  
Vol 88 (6) ◽  
pp. 206-207 ◽  
Author(s):  
BM Frost ◽  
C Beaton ◽  
AN Hopper ◽  
MR Stephens ◽  
WG Lewis
Keyword(s):  
Surgical Training ◽  
Medical Profession ◽  
Junior Doctors ◽  
Training Outcomes ◽  
Mixed Response ◽  
Surgical Trainees ◽  
European Working ◽  
The Uk ◽  
Working Time Directive ◽  
The New Deal

The European Working Time Directive (EWTD) represents the latest challenge to surgical training in the UK, following Calmanisation and the implementation of the New Deal on junior doctors' hours. Compliance with the EWTD in the UK demands shift working patterns and as such it has received a mixed response from the UK medical profession. While physicians in training are relatively content with the regulations of the EWTD, surgical trainees have voiced concerns regarding the potential impact of an altered working week on their clinical experience and training as well as quality of life.

Training in the MMC Era: Procedure-Based Assessments – the Parents' Perspective

2011 ◽  
Vol 93 (5) ◽  
pp. 1-3
Author(s):  
RM Nataraja ◽  
SC Blackburn Department ◽  
D Rawat ◽  
E Benjamin ◽  
SA Clarke ◽  
...  
Keyword(s):  
Postgraduate Medical Education ◽  
Assessment System ◽  
Medical Careers ◽  
Surgical Trainees ◽  
Medical Education And Training ◽  
European Working ◽  
Technical Competencies ◽  
Competency Based ◽  
The Uk

The recent implementation of Modernising Medical Careers (MMC) has had a significant impact on the way that both medical and surgical trainees in the UK are trained and clinically or technically assessed. The aim of MMC is 'to drive up the quality of care for patients through reform and improvement in postgraduate medical education and training'. Surgical training has also been affected by the final stage of the implementation of the European Working Time Regulations. One of the primary changes in MMC has been the introduction of a formal assessment system of the trainees. The new system was initiated to progress towards more competency-based training rather than the total time spent in training. The trainee's progress in achieving clinical and technical competencies is assessed, as is the quality of the trainee and the training he or she receives.

The effect of the EWTD on surgical SpRs: a regional survey

2008 ◽  
Vol 90 (2) ◽  
pp. 68-70 ◽  
Author(s):  
K Grover ◽  
M Gatt ◽  
J MacFie
Keyword(s):  
Rest Period ◽  
Working Time ◽  
Junior Doctors ◽  
The European Union ◽  
Regional Survey ◽  
Surgical Trainees ◽  
European Court ◽  
European Working ◽  
The Uk ◽  
Working Time Directive

The implementation of the European Working Time Directive (EWTD) has changed the way surgical training is delivered in the European Union. The Jaeger ruling by the European Court of Justice states that health service employers must guarantee an 11-hour rest period within any 24-hour time period, while the SiMAP ruling has enshrined the concept of all time spent at work being classified as working time. To comply with these rulings, as of August 2004 most NHS Trusts across the UK have implemented shift systems for junior doctors. Numerous factors influence an individual's ability to adapt to working shifts and this has major implications both for patients and for surgical trainees.

Making the Most of Surgical Training

2009 ◽  
Vol 91 (5) ◽  
pp. 164-167 ◽  
Author(s):  
Hayley Allan ◽  
Stella Vig
Keyword(s):  
Surgical Training ◽  
Working Time ◽  
European Working Time Directive ◽  
Training Time ◽  
Surgical Disease ◽  
Surgical Trainees ◽  
European Working ◽  
The Hours ◽  
Working Time Directive

It is widely believed that it is impossible to train surgical trainees to Certificate of Completion of Training (CCT)-level in a mere 48-hour week; that trainees cannot gain sufficient exposure to surgical disease or carry out an acceptable number of procedures to gain the confidence and competence for CCT within the time now available. The European Working Time Directive (EWTD) is a reality and hospitals are already implementing strict controls to ensure its trainees do not exceed the hours they are allowed to work, resulting in a consultant-led service that further restricts training time and opportunity.

Changes in working patterns hit emergency general surgical training

2008 ◽  
Vol 90 (2) ◽  
pp. 60-63 ◽  
Author(s):  
N Kara ◽  
PV Patil ◽  
SM Shimi
Keyword(s):  
Surgical Training ◽  
Working Hours ◽  
Working Time ◽  
European Working Time Directive ◽  
Confidential Enquiry ◽  
Surgical Trainees ◽  
European Working ◽  
Level Of Experience ◽  
Working Time Directive

The last decade has seen major changes in the working pattern of surgical trainees. This commenced with the introduction of the maximum 72-hour working week in 1991. The European Working Time Directive reduced the working hours to a maximum of 56 hours, with the intention to reduce it further to 48 hours by 2009. This is additionally affected by compliance with the SiMAP and Jaeger Rulings. The results of the Calman report coupled with those of the Confidential Enquiry into Perioperative Deaths (CEPOD) report have also had a significant effect on the amount and level of experience obtained during surgical training.

Outpatient Clinics: A Lost Training Opportunity?

2013 ◽  
Vol 95 (2) ◽  
pp. 1-4
Author(s):  
J A Milburn ◽  
J Brittenden ◽  
P Bachoo
Keyword(s):  
Working Hours ◽  
Technical Skills ◽  
Skills Training ◽  
Training Opportunity ◽  
Surgical Trainees ◽  
European Working ◽  
Technical Competencies ◽  
The Uk ◽  
Technical Skills Training ◽  
The New Deal

As a consequence of the introduction of the European Working Time Regulations and the New Deal, there has been a significant reduction in the number of hours worked by surgical trainees in the UK and Europe. A number of studies have highlighted how reduced working hours have negatively affected operative exposure in surgical specialties. Surgical training requires the accumulation of increasingly complex technical competencies. In order to produce a complete surgeon, these competencies must be complemented by non-technical skills. Traditionally, these have been acquired through ward and outpatient experience without strict time limitation. With reduced daytime clinical experience, not only will there be a reduction in technical skills training but inevitably reduced outpatient clinic (OPC) experience.

Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

2021 ◽  
Vol 82 (3) ◽  
pp. 1-10
Author(s):  
Soumya Mukherjee ◽  
James Meacock ◽  
Eleanor Kissane ◽  
Debasish Pal
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Medical Training ◽  
Working Hours ◽  
Junior Doctors ◽  
Clinical Experiences ◽  
Postgraduate Medical Training ◽  
European Working ◽  
Working Time Directive ◽  
The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

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